Provider Demographics
NPI:1144108036
Name:HERNANDEZ, JAREN JURIAN
Entity type:Individual
Prefix:
First Name:JAREN
Middle Name:JURIAN
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 S RIFE MEDICAL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1457
Mailing Address - Country:US
Mailing Address - Phone:479-338-3030
Mailing Address - Fax:479-338-3079
Practice Address - Street 1:2708 S RIFE MEDICAL LN
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:479-338-3030
Practice Address - Fax:479-338-3079
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-1445363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant